IACHR refers case on Argentina to the Inter-American Court

March 10, 2021

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Washington, D.C.- The Inter-American Commission on Human Rights (IACHR) filed the case of Cristina Britez Arce and family regarding Argentina before the Inter-American Court of Human Rights on February 25, 2021. The case concerns the international responsibility of Argentina for the facts related to the death of Cristina Britez Arce and the lack of due diligence in the investigation and judicial proceedings that followed in this regard.

Cristina Britez Arce, who was nine months pregnant, presented herself at the Sardá Public Hospital in 1992, claiming lumbar discomfort, fever and slight loss of fluid from her genitals. She underwent an ultrasound scan, which showed a dead fetus, and she was admitted to the hospital to induce labor. According to the death certificate, the victim died that same day from "non-traumatic cardio respiratory arrest".

In its Merits Report, the Commission indicated that it was not its responsibility to determine the cause of death of Mrs. Britez. It also indicated that it did not have to determine the value of the expert opinions carried out at the domestic level, but it did have to establish whether the State acted diligently and did what was reasonably expected to protect the rights of Mrs. Britez and prevent her death, in accordance with its international obligations. In this sense, the Commission considered that when analyzing the case, the condition of pregnancy, treatment and death in a public hospital, and the special duties of the State deriving from such condition should be taken into account, so that the State could prove that it had provided adequate and comprehensive health care to Mrs. Cristina Britez Arce.

The Commission concluded that the doctors did not act diligently to safeguard the victim's rights to health, life and personal integrity. First, the Commission observed that the State did not present information demonstrating that Mrs. Britez had been provided with information or specific care recommendations to prevent hypertension, despite being aware of her history of pre-eclampsia in a previous pregnancy.

Secondly, the Commission noted the existence of at least two important risk factors that were not disproved, and which the doctors who attended the victim during her check-ups should have taken into account. These are the significant weight gain and the history of preeclampsia in a previous pregnancy. In addition, in one of her check-ups, Mrs. Britez presented a blood pressure of 130/90, a measurement that according to the parameters of the World Health Organization can be an indication of pre-eclampsia. Thirdly, the Commission observed that the cause of death could have been undiagnosed or untreated preeclampsia, and that there was no exhaustive control based on the required techniques, which were not complex in nature. This, despite the fact that it was a high-risk pregnancy.

The Commission also noted that the care provided to the victim was determined by some experts to be "terrible", who indicated that "there was poor management of the woman that resulted in the death of the fetus". The Commission also took note of the information indicating that Mrs. Britez had been subjected to anguish and stress in the moments prior to her death.

Finally, as a fourth point, the Commission established that the investigation did not justify that the doctors acted appropriately, in accordance with the specific circumstances that the condition and development of the pregnancy warranted. In this sense, the expert opinions that were performed in the present case and that contain explicit references to the inadequacy of the care provided were not refuted.

In view of the foregoing, the Commission concluded that the Argentine State did not prove that it had acted diligently and adopted the measures that were reasonably required to safeguard her rights. Such omissions occurred despite the special duty of the State to protect the rights of Mrs. Britez as a pregnant woman, which, as indicated above, required the adoption of specific measures due to her condition as a woman and her situation during pregnancy.

On the other hand, the Commission emphasized that, in the various judicial instances, as well as in the expert opinions, the impossibility of knowing with certainty the cause of death was emphasized because the autopsy was not performed immediately after the death occurred. Furthermore, the decisions at the internal level, both in the criminal and civil spheres, were based mainly on the result of the expert opinions that were carried out with the information contained in the medical records. The Commission noted in this regard that Mrs. Britez's next of kin questioned the validity of the medical records on several occasions, stating in detail that they showed evidence of having been adulterated. However, the Commission did not note the existence of any line of investigation specifically aimed at clarifying the validity of the medical records.

In its Merits Report, the Commission recommended that the State:

1. Make full reparation for the human rights violations declared in the merits report, both in material and non-material aspects. The State shall adopt the measures of economic compensation and satisfaction in favor of the victim's next of kin, identified in the merits report.

2. Provide the mental health care measures that Ezequiel Martín and Vanina Verónica Avaro require, if they so wish and in a concerted manner.

3. To provide the necessary training measures so that health personnel attending pregnant women and/or women in labor, both in public and private hospitals, are aware of the standards established in the report.

A principal, autonomous body of the Organization of American States (OAS), the IACHR derives its mandate from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has a mandate to promote respect for and to defend human rights in the region and acts as a consultative body to the OAS in this area. The Commission is composed of seven independent members who are elected in an individual capacity by the OAS General Assembly and who do not represent their countries of origin or residence.

No. 057/21